When Should I Massage After Breast Implant Revision?

Normally, I recommend starting to massage the breasts at 3 weeks post-op. However, any time after 3 weeks would be fine. Before that would be considered too early, but it's never too late.

Thank you for your question.If you find that your breast is tight and particularly if you went up a few cup sizes, then breast massage will help your implants settle. I typically recommend waiting a week as it sooner may be too uncomfortable. However, if you can tolerate it earlier, then you can do so. I also recommend lymphatic massage as this helps to reduce swelling much faster in the breast.As far as how to massage, I recommend displacing the implant in all four directions (up, down, left and right). Example, pinch the breast on the top to displace the implant downwards. For the lymphatic massage, it is much more of a light gentle touch. We often recommend a massage therapist to help with this or we show patients how to do this at home. You can repeat this several times a day.

Not all plastic surgeons recommend massage, but I happen to think it helpful for smooth implants: both saline and silicone. Textured implants do not need massage.  For my patients I recommend starting 2 weeks after surgery for most and it is never too late to start. Check with your surgeon to see if it is right for you.

this is a controversial subject, some surgeons don't even believe it is useful to massage the implants, in any case it wont hurt and its not too late. please check with your surgeon and follow his/her advise for your particular situation.

Not everyone agrees with the necessity or even the wisdom of massaging breast implants after surgery. It originally stared as an idea to minimize the chances of developing a capsular contracture, but there is no good evidence that it helps in that regard. If your plastic surgeon did not give you specific instructions about it by 7 weeks post-op, then don't worry about it. If you aren't sure then ask your plastic surgeon for advice.

Whether or not implant massage is done postoperatively depends on the type of implant and surgeon preference.  Generally I have my patients start implant massage one week out from surgery, but generally I used smooth walled implants.  Patients with textured implants do not need massage, in fact if they are anatomically shaped this could cause real problems.  It would be best to consult your plastic surgeon.  As for timing, the same goes.  Best of luck to you.

Dear breast revision patient,

   Unfortunately, you did not give us adequete information about your surgery. If you had only implants replacement , than massage is not necessary. If you had also capsulotomy with the implants replacement, in my practice I recommend to start displacement massage after 3 days. Since you are 7 weeks after surgery, the capsule is quite established and strong and the massage will not be as efficient, but it will still help. If you had capsulorrhaphy ( Internal bra ) with the  implants replacement , massage is contra indicated. I hope that your surgeon was an experienced board certified plastic surgeon.

         All the best,

                                        Dr Widder

 

Dear Mandora,Thank you for your post. It is not too late to start massage at 7 weeks.  I depends on what the purpose of the massage is.  If to help prevention of capsular contraction, then this should be done for the life of the implants.  Unfortunately, capsular contraction can happen at any time, even 10 years down the road. Whether or not you have smooth or textured implants, however, you should follow some sort of massage technique. Massage is not a full proof prevention of capsular contracture, but it helps.  If you are doing massage for positioning, then follow below.There are many reasons why one would want to do breast massage after surgery. These include, 1. to try to massage an implant into place that is assymetric with the other side, 2. to try to massage implants down that are too high, 3. to try to massage a constricted area of the breast to loosen up, as in tubular breasts, and finally 4. to try to prevent capsular contraction around the breasts. As you probably have guessed, the type of massage for these different issues will be different as we are trying to accomplish different things. If the massage is done incorrectly, or past the point of symmetry when trying to lower an implant, then yes, it can cause bottoming out or widening. Follow these guidelines to avoid this. Your implants will get softer natually as the swelling goes down, so you should always follow your particular doctors recommendations regarding massage. These are the instructions I give my patients:1. When the implants are assymetric, or appear to be at different levels or height, then the massage is different from side to side. This occurs sometimes if the implants are placed under the muscle and one muscle is released slightly different from the other side, or the muscle is naturally larger or different shape from the other side. Sometimes massage is performed to one breast only, and sometimes to both breasts but in different directions. You should ask your surgeon for specific instructions as every situation is different, but in general, think of the breast as a 'circle', and massage with significant breast on the opposite side of the circle that you want the implants to go. You have to feel an actual stretch in the tissues in the area that the implant need to go for this to be of benefit, otherwise you are not really accomplishing anything. If the massage is in the direction of the incision, I usually protect the incision with steri-strips in order to keep the scar from widening in the early first 3 months during the massage. The massage needs to be finished in the first three months and started early, otherwise it will have little to no benefit. Look at the breasts and analyze the symmetry and where the deficient areas are to make a nice smooth beautiful contour, and stop once that goal is achieved.2. When the implants are high, and have not dropped, but are symmetric, some physicians use a tension band on top of the breasts, some ask the patient to go without a bra and allow gravity to slowly move the implants, some do a similar massage to the above but doing exactly the same thing on both sides. Consult with your physician on this.3. When there is a constricted breast like tubular breasts, I sometimes have the patient massage as in #1, sometimes have them massage both sides of the 'circle' to loosen the constricted skin, and usually leave the patient out of a bra if both sides have tubular breasts or constriction at the bottom, or if only one side is constricted, have the patient wear a bra, but cutting out he cup on the side that is constricted, so that only the normal side is supported.4. Finally, maintenance massage. I disagree with surgeons who want to keep the pocket or 'capsule' of the breast where the implant is contained larger than the implant. This aids in the implant becoming more and more displaced over time, with more separation at the cleavage point especially when you lay down, and can also cause sagging of the breasts. I actually use textured implants as a way to fight the implants moving inside the capsule of the breast so that they stay 'perky'. Natural 'perky' breasts stay in place when standing up or laying down, so 'perky' implants should do the same. I think the implant should fit in the capsule or breast pocket like a glove, and actually be adhesive to it. Thus there is a 'perfect' amount of massage that is necessary to keep this capsule flexible, but not wider than the actual implant and thus allow for movement of the implant and thus sag. I like grabbing the breast and pressing the opposite sides of the 'circle' toward the center, causing the central or nipple area to bulge out. I have my patients do this pushing the top and bottom together, the sides together, and then both diagonals together. This puts more pressure on the central portion of the implant, rather than the sides to allow the implant to continue to be adhesive, but the capsule to not widen. I ask my patients to develop a routine and do it in their morning shower, this way it becomes habitual and they won't forget, as this is a lifelong routine that should be performed.Best Wishes,Pablo Prichard, MD

While it is not too late to start, your surgeon will be best to guide you based on the specifics of your case on whether you should start.

Thank you for your question. I don't think its too late, but your surgeon should be able to tell whether you need it or not.